title: Human papillomavirus and cervical cancer in Australasia and Oceania: risk-factors, epidemiology and prevention.
abstract: The region encompassing Australasia and Oceania, including Australia, New Zealand, Fiji and Papua New Guinea, is a diverse one with respect to ethnicities, cultures and behaviours. It includes countries with comprehensive cervical cytology screening programmes which can be credited with significant reductions in cervical cancer incidence and mortality, and countries with no prevention programmes and significantly higher incidence and mortality. As elsewhere in the world, human papillomavirus (HPV)-16 and 18 are the commonest high-risk types, with the highest rates in women under 25 years of age. These two high-risk HPV types are found most frequently in cervical cancers and high-grade dysplasias, although there are minimal data for many countries in Oceania. In April 2007, Australia became the first country worldwide to commence a government funded universal HPV vaccine programme. The school-based programme targets 12-year old females in an ongoing schedule, with a catch-up programme up to 26 years of age, to be completed in mid-2009. Vaccine introduction has been comprehensively rolled out, with around 75% uptake of the complete vaccine schedule among school-girls in the first year of this initiative. This represents a successful model for other countries. We present data on cervical cancer, risk factors and prevention strategies, including epidemiology of HPV and HPV vaccine strategies.
authors.affiliation: Department of Microbiology and Infectious Diseases, The Royal Women's Hospital, Melbourne, Victoria, Australia. Sue.Garland@thewomens.org.au
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Garland
authors.forename: Julia M L
authors.initials: JM
authors.lastname: Brotherton
authors.forename: S Rachel
authors.initials: SR
authors.lastname: Skinner
authors.forename: Marian
authors.initials: M
authors.lastname: Pitts
authors.forename: Marion
authors.initials: M
authors.lastname: Saville
authors.forename: Glen
authors.initials: G
authors.lastname: Mola
authors.forename: Ronald W
authors.initials: RW
authors.lastname: Jones
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001315:Australia / Q000453:epidemiology; D002648:Child; D005260:Female; D005367:Fiji / Q000453:epidemiology; D006078:Government Programs / Q000592:standards; D006291:Health Policy; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D015994:Incidence; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D010219:Papua New Guinea / Q000453:epidemiology; D012307:Risk Factors; D012907:Smoking; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control* / Q000821:virology; D014611:Vaccination; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines